Speaking at the RCGP annual conference in Harrogate last week, Professor Steve Field acknowledged GPs' doubts. There were concerns, he said, that it could be the 'worst thing to happen to the NHS ever' because of fears it could increase the role of the private sector.
'These reforms are probably the biggest since the NHS began,' he said. 'They are not without risks, but there is the opportunity for GPs to design better care for our patients.'
The RCGP backed the direction of travel, he said, because the White Paper 'proposes what we have been calling for for years - greater involvement and leadership from GPs'.
Former health minister Lord Darzi had done 'a great job of putting quality at the heart of the NHS', Professor Field argued. But PCTs and SHAs had failed to deliver on promises to hand clinicians key roles. It was no surprise the Labour government's World Class Commissioning scheme failed as a result, he said.
Professor Field listed a host of problems with GP training and patient services that commissioners would need to address.
PCTs had failed to tackle poor performance, he said. Revalidation would not have been necessary if PCTs had 'got their act together' and properly implemented appraisal, but the RCGP had been forced to 'react where the service had failed'.
Only a small percentage of GPs were underperforming, but this still meant many people were not receiving high quality care, Professor Field warned.
Large numbers of patients, including travellers, sex workers, the homeless and asylum seekers 'do not get access even to poor care', he added.
Professor Field warned that young GPs were not gaining the experience that previous generations enjoyed, and standards of care may suffer and referrals rise as a result.
He said warnings that Darzi centres and PFI hospital deals were expensive and unnecessary in many areas had been proven correct. He also urged GPs to 'grow up and share information' to improve services, and to build links with charities and local authorities.
